What the CDC has to say about HIV and BBBJ's:

ANONONE's Avatar
I did not want to continue fueling the hi-jacking of the "better tasting semen" thread with this post, and instead thought it would be helpful to have this put into perpetuity in a central location to stand alone for folks that want medical facts whenever this hot issues rises, which seems to be every few weeks.

Here is what the CDC has to say about the BBBJ:



Not having sex is the best way to protect against the transmission of HIV.

But if you are having sex, it’s important to know that all sex is not the same when it comes to transmitting HIV. For instance insertive oral sex without a condom has a low risk for HIV transmission (about 1 in 4,000) and in each of these cases the transmission actually occurred as a direct result of open sores and cuts on either the penis or the mouth of one of the partners. It should also be noted that in each of these cases other unprotected sexual activity was conducted. There are no known cases of HIV as the result of strictly orogenital contact. While some studies have shown a very low level of infected cells can be present in both semen and pre-ejaculate fluid, the virus does not live long outside the body and saliva has indeed shown the ability to inhibit if not kill the virus. Saliva that does not contain blood presents no potential for transmission, as research has shown that an enzyme in saliva inhibits HIV. In general, the mouth and throat are well defended against HIV: the oral mucosal lining contains few of the cells that are the most susceptible to HIV.28 Other research notes that saliva contains several HIV inhibitors, such as peroxidases and thrombospondin-1, and that the hypotonicity of saliva disrupts the transmission of infected leukocytes (white blood cells).

Recent studies indicate that the population-attributable risk percentage (PAR%) for HIV prevalence associated with fellatio while using a condom is 0.18% and without a condom 0.14% if that is the only sexual activity that is unprotected.


References:

1. Centers for Disease Control and Prevention. Incorporating HIV Prevention into the Medical Care of Persons Living with HIV:
Recommendations of CDC, the Health Resources and Services Administration, the National Institutes of Health, and the HIV
Medicine Association of the Infectious Diseases Society of America. MMWR 2003;52(RR-12):1–24.
2. Varghese B, Maher JE, Peterman TA, Branson, BM, Steketee RW. Reducing the risk of sexual HIV transmission: quantifying the
per-act risk for HIV infection based on choice of partner, sex act, and condom use. Sexually Transmitted Diseases 2002;29:38–43.
3. Centers for Disease Control and Prevention. HIV/AIDS Questions and Answers. Available at: www.cdc.gov.
4. Centers for Disease Control and Prevention. HIV testing among pregnant women—United States and Canada, 1998-2001.
MMWR 2002;51(45):1013–1016.
5. Dorenbaum A, Cunningham CK, Gelber RD, et al. Two-dose intrapartum/newborn nevirapine and standard antiretroviral
therapy to reduce perinatal HIV transmission: a randomized trial. Journal of the American Medical Association 2002;288:189–198.
6. Centers for Disease Control and Prevention. Is there a connection between HIV and other sexually transmitted diseases? Available at www.cdc.gov
billstanis6's Avatar
Great info Anonoe!
Utanks's Avatar
Recent studies indicate that the population-attributable risk percentage (PAR%) for HIV prevalence associated with fellatio while using a condom is 0.18% and without a condom 0.14% if that is the only sexual activity that is unprotected.
Am I misreading that, or is PAR a specific calculated variable? The above indicates that the % of risk is actually higher by .04% with a condom than without? Just caught my eye and thought I'd point out if the numbers are reversed or if a lower PAR % is actually means higher risk?
ANONONE's Avatar
Am I misreading that, or is PAR a specific calculated variable? The above indicates that the % of risk is actually higher by .04% with a condom than without? Just caught my eye and thought I'd point out if the numbers are reversed or if a lower PAR % is actually means higher risk? Originally Posted by Utanks
Math is not my forte, but I think the PAR is calculated to show what the attributed risk is with a given activity. I think the point the researcher was making is that there is little or no change when it comes to orogenital contact with regards to condom use.

Is a .04% variation even statistically relevant?
  • npita
  • 05-14-2010, 08:32 AM
The most well-controlled study to date (of which I am aware) was done by the UCSF Center for AIDS Prevention Studies. The conclusion is that the risk of contracting HIV for the recipient performing oral sex on an infected partner without a condom (with or without ejaculation) is essentially zero.

http://news.ucsf.edu/releases/ucsf-s...tive-oral-sex/



Am I misreading that, or is PAR a specific calculated variable? The above indicates that the % of risk is actually higher by .04% with a condom than without? Just caught my eye and thought I'd point out if the numbers are reversed or if a lower PAR % is actually means higher risk?
You're misreading that in two ways. First, the number was 0.14, not 0.04. Second, from what I can tell from the quoted text, the population attributable risk (PAR) probably means the incidence of HIV transmission they attribute oral sex relative to all transmission, so for example, if your chances of acquiring HIV through any mode of transmission is 1 in 500, then your chances of acquiring it through unprotected oral sex (0.018% PAR) would be 1 in about 2.8 million. That number would also be consistent with UCSF study which puts the chances at about zero.
HIV is not the only STD. From http://www.stanford.edu/group/SHPRC/ch4_ora.html

Oral Sex
Many people are unclear on the risks associated with oral sex. Questions about oral sex and the risk of contracting an STD are very common in outreaches and at the SHPRC. Many people engage in unprotected oral sex, and are particularly concerned with the risks associated with not using protection.
What are the risks:
  • Herpes is probably the biggest STD risk during oral sex. Both strains of herpes can live in the mouth or the genitals, and particularly during outbreaks (cold sores, herpes lesions) can be passed from one place to the other. Many people have oral herpes, more than 50% of a random group of people will have antibodies to the virus (indicating some level of infection). Having oral herpes for most people is no big deal, a cold sore during times of stress or illness is usually little more than an annoyance. Genital herpes can be more complicated and uncomfortable, but there are treatments (see Herpes Fact Sheet for more info). Care should be taken so that oral herpes are not passed to anyone’s genitals. In general it is not a good idea to have unprotected oral sex while any lesions are present.
  • Chlamydia and gonorrhea can infect your throat, strep like symptoms, and are curable with antibiotics. These can also infect the eye, and though rare, eye infections can have serious consequences, so be careful with fluids.
  • HIV can be passed through unprotected oral sex, but it is more likely to be passed during unprotected penetrative sex. The infected semen/precum or vaginal fluid must enter the body through a cut or sore in the mouth or esophagus. The virus is unlikely to be passed from a person’s mouth to another person’s genitals.
  • HPV can be passed during oral sex, but it is rare. HPV has been found on vocal chords.
  • Syphilis can be passed similar to HIV. Syphilis is curable.
  • Hepatitis A is a risk particularly in oral-anal sex, and people engaging in this unprotected might want to look into getting a Hep A vaccine. Hep A is not a chronic condition like Hep B and C, but can make a person quite sick several weeks.
Reducing Risks:
  • To reduce the risk of infection during unprotected oral sex, limit exposure to sexual fluids and ensure that no cuts or lesions are present in mouth or on genitals.
  • Use barrier methods — though many people feel that barrier methods detract from oral sex, they are very effective at preventing STD transmission:
    • Oral-penile sex: Male condom, no spermicide (kills taste buds), flavored condoms are available.
    • Oral-vaginal sex: Dental dams (aka Lollys) — can buy them, or you can use non-microwaveable saran wrap, or cut up a latex glove.
    • Oral-anal sex: Dental dams, non-microwaveable saran wrap, cut up latex glove
  • Spit or swallow? Limiting exposure to semen reduces risk of infection, so ejaculation away from partner’s body is the safest. That said, the mouth is the place most likely to contract something like HIV, so the conventional wisdom is, “swallow or spit, just don’t let it sit.”
  • npita
  • 05-14-2010, 09:48 AM
HIV is not the only STD. Originally Posted by TxBrandy
That is true, but the only STD this thread is about is HIV,
well from a point of catching the unimaginable....bbbj is relatively safe. worst case....do an oral exam....open wide sweetheart....gargle with listerine to kill off any bacteria. then enjoy the nut in mouth combo.....hell yeah...

great post ANONONE
Great thread, and thank you for the extra info, Brandy. This is why I love this board.
The conclusion is that the risk of contracting HIV for the recipient performing oral sex on an infected partner without a condom (with or without ejaculation) is essentially zero. Originally Posted by npita
Hmmmm. Very interesting. I guess the key word here is "essentially".

It brings to mind a big discussion/uproar years back on the P.

A long time regular of mine and I had just finished a great session and were laying around and talking and relaxing after the fun.

The subject came up about STDs. He told me of a big discussion in the Mens Room about a provider in a state near Texas that supposedly had admitted she had Hepatitis C. Hobbyists were falling over one another, demanding to know who she was. They wanted to know because noone wanted to go near her-wouldn't touch her with a ten foot pole. Her name was apparently outed eventually, and it turned out she indeed admitted it, but claimed it was "under control"(whatever that means). But still, even though she was pretty hot(he said), noone wanted to have a session with her(I don't blame them BTW).

Well, why not?

After all, if she gave the hobbyist a CBJ and it was CFS the risk was "essentially zero". Right?

But no, no hobbyist was willing to take even the SLIGHTEST risk of endangering his health.

So why is it that providers are asked to do things that entail a risk to OUR health-even though it might also be "slight".

Seems like a double standard to me..but then again we are only providers, and OUR health and well being aren't quite as important..as the hobbyists..
So why is it that providers are asked to do things that entail a risk to OUR health-even though it might also be "slight".

Seems like a double standard to me..but then again we are only providers, and OUR health and well being aren't quite as important..as the hobbyists.. Originally Posted by Sweet Heather
I certainly have no double standard. In a session with a provider, I accept all of the risks that she does. I respect her right to say "no" to anything; and in exchange I expect her to respect my right to say no too.

Most certainly, I respect your right not to perform X or Y sex act.

But it is time to cut to the chase here about risks.

There has never been a single case, out of millions, of HIV provably attributable to oral sex. Not even ONE. While it is POSSIBLE, just like it is POSSIBLE that I am an alien from outer space; one should be realistic about the HIV risks which -- so far in human experience -- amount to ZERO.

You are FAR more likely to get oral herpes from kissing someone since 50% of people are infected with it. Do you KISS? Even just a light peck on the lips?

You could also catch colds, deadly flu and a host of other ailments from just kissing including mononucleosis.

Hell, according to Dr. Paul Ewald, you could likely contract a great many illnesses currently attributed to lifestyle by correlation rather than causation; among them atherosclerosis and certain forms of cancer. (1)

Just from KISSING.

Again ... I don't want you to expose yourself to even the SLIGHTEST risk; especially of serious diseases that could kill you. So you should really leave kissing off your menu because a guy walking in your door is far more likely to have the germs to which atherosclerosis is attributable than HIV.

Also, touching has to come off the menu. It turns out a lot of flu -- which kills a LOT of people every year -- is easily transmitted just by hands. A guy walking in your door is a LOT more likely to have flu germs on his hands than HIV.

Also, sexual intercourse, even covered, has to come off the menu. Look it up. Both herpes and HPV can be transmitted, even using a condom. As I said, I don't want you at risk. HPV could kill you; and herpes sometimes has major complications including permanent brain damage.

My point, in case I am beating around the bush too much; is that I think your argument against CIM based upon your unwillingness to accept HIV risks is not well-reasoned. If health risks were the true operative factor; you would already have dropped a great many things off your menu that have far greater risks including kissing, covered sex, and touching.

Rather, Heather, I believe you have a far superior and indisputable argument at your disposal which I am guaranteed to respect.

The argument goes like this: "It is MY mouth, and I get to decide what goes in there and under what conditions."

NO reasonable person would dispute that.

Be safe.


(1) http://www.amazon.com/Plague-Time-Ge.../dp/0385721846
There's nothin' like good news...
Nevermind.
My point, in case I am beating around the bush too much; is that I think your argument against CIM based upon your unwillingness to accept HIV risks is not well-reasoned. If health risks were the true operative factor; you would already have dropped a great many things off your menu that have far greater risks including kissing, covered sex, and touching.
Originally Posted by Laurentius
Point taken, and I thank you for sharing. And thank you for sharing without being condesending. Or mean. Kisses, Heather
Point taken, and I thank you for sharing. And thank you for sharing without being condesending. Or mean. Kisses, Heather Originally Posted by Sweet Heather
The medium of a forum makes it difficult to convey things as we would in person -- it's surprising how much we rely on facial expressions, body language and the like.

IF I come across as mean or condescending; you can be certain it is not intended.

I KNOW your job ain't easy.